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食管活检中嗜酸性粒细胞定量的额外复查价值。

Value of an Additional Review for Eosinophil Quantification in Esophageal Biopsies.

作者信息

Stucke Emily M, Clarridge Katherine E, Collins Margaret H, Henderson Carol J, Martin Lisa J, Rothenberg Marc E

机构信息

*Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center †Department of Pediatrics, University of Cincinnati College of Medicine ‡Division of Pathology and Laboratory Medicine §Division of Human Genetics ||Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

出版信息

J Pediatr Gastroenterol Nutr. 2015 Jul;61(1):65-8. doi: 10.1097/MPG.0000000000000740.

Abstract

Eosinophilic esophagitis (EoE) requires a peak count of 15 eosinophils per high-power field (hpf). Herein, the peak eosinophil count specified by a pathologist was compared with the second review of a research assistant. Of 477 biopsies, 106 had a peak count between 1 and 14 eosinophils/hpf cited in the pathology report, and 23/106 (22%) had ≥15 eosinophils/hpf on second review. The pathology report detected potential EoE with 99% specificity, but 80% sensitivity. As such, an additional review of esophageal biopsies yields higher eosinophil counts in ∼5% of cases. We propose that biopsies with a count between 1 and 14 eosinophils/hpf require further investigation because ∼22% may yield a potential EoE diagnosis.

摘要

嗜酸性食管炎(EoE)要求每高倍视野(hpf)嗜酸性粒细胞峰值计数达到15个。在此,将病理学家指定的嗜酸性粒细胞峰值计数与研究助理的二次复查结果进行了比较。在477份活检样本中,病理报告显示106份的嗜酸性粒细胞峰值计数在1至14个/hpf之间,其中23/106(22%)在二次复查时嗜酸性粒细胞计数≥15个/hpf。病理报告检测潜在EoE的特异性为99%,但敏感性为80%。因此,对食管活检样本进行额外复查会使约5%的病例嗜酸性粒细胞计数更高。我们建议,嗜酸性粒细胞计数在1至14个/hpf之间的活检样本需要进一步检查,因为约22%的此类样本可能得出潜在EoE的诊断结果。

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本文引用的文献

1
Eosinophilic esophagitis: updated consensus recommendations for children and adults.嗜酸粒细胞性食管炎:儿童和成人的最新共识建议。
J Allergy Clin Immunol. 2011 Jul;128(1):3-20.e6; quiz 21-2. doi: 10.1016/j.jaci.2011.02.040. Epub 2011 Apr 7.
6
Variability in diagnostic criteria for eosinophilic esophagitis: a systematic review.嗜酸性食管炎诊断标准的变异性:一项系统评价。
Am J Gastroenterol. 2007 Oct;102(10):2300-13. doi: 10.1111/j.1572-0241.2007.01396.x. Epub 2007 Jul 7.

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